Evaluation of the Heart of Birmingham teaching Primary Care Trust (HoBtPCT): My Choice Weight Management Programme:report commissioned by Heart of Birmingham teaching Primary Care Trust

This report details an evaluation of the My Choice Weight Management Programme undertaken by a research team from the School of Pharmacy at Aston University. The My Choice Weight Management Programme is delivered through community pharmacies and general practitioners (GPs) contracted to provide services by the Heart of Birmingham teaching Primary Care Trust. It is designed to support individuals who are ‘ready to change’ by enabling the individual to work with a trained healthcare worker (for example, a healthcare assistant, practice nurse or pharmacy assistant) to develop a care plan designed to enable the individual to lose 5-10% of their current weight. The Programme aims to reduce adult obesity levels; improve access to overweight and obesity management services in primary care; improve diet and nutrition; promote healthy weight and increased levels of physical activity in overweight or obese patients; and support patients to make lifestyle changes to enable them to lose weight. The Programme is available for obese patients over 18 years old who have a Body Mass Index (BMI) greater than 30 kg/m2 (greater than 25 kg/m2 in Asian patients) or greater than 28 kg/m2 (greater than 23.5 kg/m2 in Asian patients) in patients with co-morbidities (diabetes, high blood pressure, cardiovascular disease). Each participant attends weekly consultations over a twelve session period (the final iteration of these weekly sessions is referred to as ‘session twelve’ in this report). They are then offered up to three follow up appointments for up to six months at two monthly intervals (the final of these follow ups, taking place at approximately nine months post recruitment, is referred to as ‘session fifteen’ in this report). A review of the literature highlights the dearth of published research on the effectiveness of primary care- or community-based weight management interventions. This report may help to address this knowledge deficit. A total of 451 individuals were recruited on to the My Choice Weight Management Programme. More participants were recruited at GP surgeries (n=268) than at community pharmacies (n=183). In total, 204 participants (GP n=102; pharmacy n=102) attended session twelve and 82 participants (GP n=22; pharmacy 60) attended session fifteen. The unique demographic characteristics of My Choice Weight Management Programme participants – participants were recruited from areas with high levels of socioeconomic deprivation and over four-fifths of participants were from Black and Minority Ethnic groups; populations which are traditionally underserved by healthcare interventions – make the achievements of the Programme particularly notable. The mean weight loss at session 12 was 3.8 kg (equivalent to a reduction of 4.0% of initial weight) among GP surgery participants and 2.4 kg (2.8%) among pharmacy participants. At session 15 mean weight loss was 2.3 kg (2.2%) among GP surgery participants and 3.4 kg (4.0%) among pharmacy participants. The My Choice Weight Management Programme improved the general health status of participants between recruitment and session twelve as measured by the validated SF-12 questionnaire. While cost data is presented in this report, it is unclear which provider type delivered the Programme more cost-effectively. Attendance rates on the Programme were consistently better among pharmacy participants than among GP participants. The opinions of programme participants (both those who attended regularly and those who failed to attend as expected) and programme providers were explored via semi-structured interviews and, in the case of the participants, a selfcompletion postal questionnaire. These data suggest that the Programme was almost uniformly popular with both the deliverers of the Programme and participants on the Programme with 83% of questionnaire respondents indicating that they would be happy to recommend the Programme to other people looking to lose weight. Our recommendations, based on the evidence provided in this report, include: a. Any consideration of an extension to the study also giving comparable consideration to an extension of the Programme evaluation. The feasibility of assigning participants to a pharmacy provider or a GP provider via a central allocation system should also be examined. This would address imbalances in participant recruitment levels between provider type and allow for more accurate comparison of the effectiveness in the delivery of the Programme between GP surgeries and community pharmacies by increasing the homogeneity of participants at each type of site and increasing the number of Programme participants overall. b. Widespread dissemination of the findings from this review of the My Choice Weight Management Project should be undertaken through a variety of channels. c. Consideration of the inclusion of the following key aspects of the My Choice Weight Management Project in any extension to the Programme: i. The provision of training to staff in GP surgeries and community pharmacies responsible for delivery of the Programme prior to patient recruitment. ii. Maintaining the level of healthcare staff input to the Programme. iii. The regular schedule of appointments with Programme participants. iv. The provision of an increased variety of printed material. d. A simplification of the data collection method used by the Programme commissioners at the individual Programme delivery sites.

Teaching and learning German language and culture in higher education in Britain:problems, challenges and didactical implications. A case study

The aim of this thesis is to explore key aspects and problems of the institutionalised teaching and learning of German language and culture in the context of German Studies in British Higher Education (HE). This investigation focuses on teaching and learning experiences in one department of German Studies in the UK, which is the micro-context of the present study, in order to provide an in-depth insight into real-life problems, strengths and weaknesses as they occur in the practice of teaching and learning German. Following Lamb (2004) and Holliday (1994), the present study acts on the assumption that each micro-context does not exist in vacuo but is always embedded in a wider socio-political and education environment, namely the macro-context, which largely determines how and what is taught. The macro-analysis of the present study surveys the socio-political developments that have recently affected the sector of modern languages and specifically the discipline of German Studies in the UK. It demonstrates the impact they have had on teaching and learning German at the undergraduate level in Britain. This context is interesting inasmuch as the situation in Britain is to a large extent a paradigmatic example of the developments in German Studies in English-speaking countries. Subsequently, the present study explores learning experiences of a group of thirty-five first year students. It focuses on their previous experiences in learning German, exposure to the target language, motivation, learning strategies and difficulties encountered, when learning German at the tertiary level. Then, on the basis of interviews with five lecturers of German, teaching experience in the context under study is explored, problems and successful teaching strategies discussed.

Maintenance of communication in primary classrooms : some evidence for the role of elicitation and code-switching in English medium schools in Kenya, with implications for teaching

This is a study of specific aspects of classroom interaction primary school level in Kenya. The study entailed the identification of the sources of particular communication problems during the change-over period from Kiswahili to English medium teaching in two primary schools. There was subsequently an examination of the language resources which were employed by teachers to maintain pupil participation in communication in the light of the occurrence of possibility of occurrence of specific communication problems. The language resources which were found to be significant in this regard concerned firstly the use of different elicitation types by teachers to stimulate pupils into giving responses and secondly teachers' recourse to code-switching from English to Kiswahili and vice-versa. It was also found in this study that although the use of English as the medium of instruction in the classrooms which were observed resulted in certain communication problems, some of these problems need not have arisen if teachers had been more careful in their use of language. The consideration of this finding, after taking into account the role of different elicitation types and code-switching as interpretable from data samples had certain implications which are specified in the study for teaching in Kenyan primary schools. The corpus for the study consisted of audio-recordings of English, Science and Number-Work lessons which were later transcribed. Relevant data samples were subsequently extracted from transcripts for analysis. Many of the samples have examples of cases of communication breakdowns, but they also illustrate how teachers maintained interaction with pupils who had yet to acquire an operational mastery of English. This study thus differs from most studies on classroom interaction because of its basic concern with the examination of the resources available to teachers for overcoming the problem areas of classroom communication.

Adapting an apprenticeship model to the needs of English-medium education at the tertiary level in Turkey

Despite the difficulties that we have regarding the use of English in tertiary education in Turkey, we argue that it is necessary for those involved to study in the medium of English. Furthermore, significant advances have been made on this front. These efforts have been for the most part language-oriented, but also include research into needs analysis and the pedagogy of team-teaching. Considering the current situation at this level of education, however, there still seems to be more to do. And the question is, what more can we do? What further contribution can we make? Or, how can we take this process further? The purpose of the study reported here is to respond to this last question. We test the proposition that it is possible to take this process further by investigating the efficient management of transition from Turkish-medium to English-medium at the tertiary level of education in Turkey. Beyond what is achieved by only the language orientation of the EAP approach, and moving conceptually deeper than what has been achieved by the team-teaching approach, the research undertaken for the purpose of this study focuses on the idea of the discourse community that people want to belong to. It then pursues an adaptation of the essentially psycho-social approach of apprenticeship, as people become aspirants and apprentices to that discourse community. In this thesis, the researcher recognises that she cannot follow all the way through to the full implementation of her ideas in a fully-taught course. She is not in a position to change the education system. What she does here is to introduce a concept and sample its effects in terms of motivation, and thereby of integration and of success, for individuals and groups of learners. Evaluation is provided by acquiring both qualitative and quantitative data concerning mature members' perceptions of apprenticed-neophytes functioning as members in the new community, apprenticed-neophytes' perceptions of their own membership and of the preparation process undertaken, and the comparison of these neophytes' performance with that of other neophytes in the community. The data obtained provide strong evidence in support of the potential usefulness of this apprenticeship model towards the declared purpose of improving the English-medium tertiary education of Turkish students in their chosen fields of study.

Disciplinary talk:a systemic functional exploration of university seminar discussions

Despite the growth of spoken academic corpora in recent years, relatively little is known about the language of seminar discussions in higher education. This thesis compares seminar discussions across three disciplinary areas. The aim of this thesis is to uncover the functions and patterns of talk used in different disciplinary discussions and to highlight language on a macro and micro level that would be useful for materials design and teaching purposes. A framework for identifying and analysing genres in spoken language based on Hallidayan Systemic Functional Linguistics (SFL) is used. Stretches of talk sharing a similar purpose and predictable functional staging, termed Discussion Macro Genres (DMGs) are identified. Language is compared across DMGs and across disciplines through use of corpus techniques in conjunction with SFL genre theory. Data for the study comprises just over 180,000 tokens and is drawn from the British Academic Spoken English corpus (BASE), recorded at two universities in the UK. The discipline areas investigated are Arts and Humanities, Social Sciences and Physical Sciences. Findings from this study make theoretical, empirical and methodological contributions to the field of spoken EAP. The empirical findings are firstly, that the majority of the seminar discussion can be assigned to one of the three main DMG in the corpus: Responding, Debating and Problem Solving. Secondly, it characterises each discipline area according to two DMGs. Thirdly, the majority of the discussion is non-oppositional in nature, suggesting that ‘debate’ is not the only form of discussion that students need to be prepared for. Finally, while some characteristics of the discussion are tied to the DMG and common across disciplines, others are discipline specific. On a theoretical level, this study shows that an SFL genre model for investigating spoken discourse can be successfully extended to investigate longer stretches of discourse than have previously been identified. The methodological contribution is to demonstrate how corpus techniques can be combined with SFL genre theory to investigate extended stretches of spoken discussion. The thesis will be of value to those working in the field of teaching spoken EAP/ ESAP as well as to materials developers.

A bridge too far? Breaching the research/learning and teaching nexus in a previously research-led university

The relationship between research and learning and teaching represents what has been described as ‘amongst the most intellectually tangled, managerially complex and politically contentious issues in mass higher education’ (Scott, 2005, p 53). Despite this, arguments that in order to achieve high quality scholarly outcomes, university teachers need to adopt an approach to teaching similar to that of research (i.e. founded upon academic rigour and evidence), has long been discussed in the literature (see for example, Elton, 2005 & Healey, 2000). However, the practicalities of promoting an empirical and evidence-based approach to teaching within a research-led institution makes dealing with the research/learning and teaching nexus a somewhat challenging proposition. Drawing upon the findings of a mixed methodological study, this paper critically analyses the pedagogical, organisational and practical issues encountered by academics and support staff working within a newly established Centre for Learning Innovation and Professional Practice. Comprising an eclectic group of staff drawn from across the five Schools in the University, the Centre is dedicated to enhancing student learning through the development of evidence based teaching practice. Based upon the premise that the promotion of research-led teaching will act to bring teaching and research together, and in doing so enhance students learning experiences (Simmons & Elen 2007), the paper critically analyses the challenges encountered by staff responsible for developing and introducing a new learning & teaching focused organisational strategy (by reflecting on the previous 12 months work). In doing so it makes a significant contribution to current academic theory and debate in the areas of pedagogic practice and organisational management. Focusing specifically on the impact of the new policy on various aspects of university life including, pedagogic practice, student support, staff training, and organisational management, the paper critically addresses the cultural and attitudinal challenges of change management (Kotter, 1996) within a ‘grey-brick’ university. It concludes by arguing that the move towards becoming a more learning-focused university has started to develop an awareness of the positive impact the change initiative is having on the student experience and wider institution; whilst also drawing attention to the organisational challenges ahead.

An integrative approach to developing an intercultural awareness strategy in a multicultural university

Universities are increasingly diverse places; in terms of staff and students, their nationality, ethnicity and religious backgrounds. HEIs need to find ways of ensuring that this diversity adds to the life of the institution and to the development of graduates as employees in a global workplace. The paper offers a case study of one way of developing an intercultural strategy at a UK university. The university concerned has a highly multicultural and multinational staff and student population. Over many years the university has worked to celebrate and embed this diversity into the culture and values of the institution; in its learning, teaching, business operations and relationships. The university wished to develop its intercultural awareness strategy in an inspirational and vibrant way, one which was informed by research and practice. The paper proposes a new integrative approach to developing an intercultural strategy, and summarises some reflections on the process of creating the intercultural awareness strategy which may be of use to other institutions. Analysis showed that in order to make the strategy effective there had to be commitment from senior management to match innovative practices at an individual level. It is also clear that such a strategy must include formal policies and procedures, as well as more informal channels to allow people to express intercultural differences and shared values. The critical role of middle management in strategy implementation is also discussed.

The sociological approach to teaching and learning in higher education with special reference to first year sociology courses at a technological university

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Predicting university success in psychology:are subject-specific skills important?

The relationship between previous academic achievement and subsequent success at university was explored in a retrospective study of 56 UK psychology students. It was found that the subjects studied at A-level, and the grades obtained, did not predict performance at university. In contrast, GCSE grades, in particular those achieved in Science and English, were significant predictors of final year marks. Once at university, first and second year results had an incremental ability to predict final year performance, with an additional effect of undertaking a work placement. The implications of the results are discussed within the context of recent literature relating to cognitive and non-cognitive predictors of academic performance.

Medicines optimisation for young people with juvenile arthritis and other long-term conditions:system-level barriers to engagement

To explore the views of pharmacy and rheumatology stakeholders about system-related barriers to medicines optimisation activities with young people with long-term conditions. A three-phase consensus-building study comprising (1) focus groups with community and hospital pharmacists; (2) semi-structured telephone interviews with lay and professional adolescent rheumatology stakeholders and pharmacy policymakers, and (3) multidisciplinary discussion groups with community and hospital pharmacists and rheumatology staff. Qualitative verbatim transcripts from phases 1 and 2 were subjected to framework analysis. Themes from phase 1 underpinned a briefing for phase 2 interviewees. Themes from phases 1 and 2 generated elements of good pharmacy practice and current/future pharmacy roles for ranking in phase 3. Results from phase 3 prioritisation and ranking exercises were captured on self-completion data collection forms, entered into an Excel spreadsheet and subjected to descriptive statistical analysis. Institutional ethical approval was given by Aston University Health and Life Sciences Research Ethics Committee. Four focus groups were conducted with 18 pharmacists across England, Scotland and Wales (7 hospital, 10 community and 1 community/public health). Fifteen stakeholders took part in telephone interviews (3 pharmacist commissioners; 2 pharmacist policymakers; 2 pharmacy staff members (1 community and 1 hospital); 4 rheumatologists; 1 specialist nurse, and 3 lay juvenile arthritis advocates). Twenty-five participants took part in three discussion groups in adolescent rheumatology centres across England and Scotland (9 community pharmacists; 4 hospital pharmacists; 6 rheumatologists; 5 specialist nurses, and 1 physiotherapist). In all phases of the study, system-level issues were acknowledged as barriers to more engagement with young people and families. Community pharmacists in the focus groups reported that opportunities for engaging with young people were low if parents collected prescriptions alone, which was agreed by other stakeholders. Moreover, institutional/company prescription collection policies – an activity largely disallowed for a young person under 16 without an accompanying parent - were identified by hospital and community pharmacists as barriers to open discussion and engagement. Few community pharmacists reported using Medicines Use Review (England/Wales) or Chronic Medication Service (Scotland) as a medicines optimisation activity with young people; many were unsure about consent procedures. Despite these limitations, rheumatology stakeholders ranked highly the potential of pharmacists empowering young people with general health care skills, such as repeat prescription ordering. The pharmacy profession lacks vision for its role in the care of young people with long-term conditions. Pharmacists and rheumatology stakeholders identified system-level barriers to more engagement with young people who take medicines regularly. We acknowledge that the modest number of participants may have had a specific interest and thus bias for the topic, but this underscores their frank admission of the challenges. Professional guidance and policy, practice frameworks and institutional/company policies must promote flexibility for pharmacy staff to recognise and empower young people who are able to give consent and take responsibility for medicines activities. This will increase mutual confidence and trust, and foster pharmacy’s role in teaching general health care skills. In this way, pharmacists will be able to build long-term relationships with young people and families.

Florida International University College of Medicine and Jackson Health System Partner to Establish New Teaching Program

Press Release from Florida International University 's Office of Media Relations on the partnership between the Florida International University College of Medicine and Jackson Health System to establish a new teaching program.

Florida International University College of Medicine and Mount Sinai Medical Center Partner to Establish New Teaching Program

Press Release from Florida International University 's Office of Media Relations on the partnership between the Florida International University College of Medicine and Mt. Sinai Medical Center to establish a new teaching program.

Geographical Literacy, Attitudes, and Experiences of Freshman Students: A Qualitative Study at Florida International University

The purpose of the study was to explore the geography literacy, attitudes and experiences of Florida International University (FIU) freshman students scoring at the low and high ends of a geography literacy survey. The Geography Literacy and ABC Models formed the conceptual framework. Participants were freshman students enrolled in the Finite Math course at FIU. Since it is assumed that students who perform poorly on geography assessments do not have an interest in the subject, testing and interviewing students allowed the researcher to explore the assumption. In Phase I, participants completed the Geography Literacy Survey (GLS) with items taken from the 2010 NAEP Geography Subject Area Assessment. The low 35% and high 20% performers were invited for Phase II, which consisted of semi-structured interviews. A total of 187 students participated in Phase I and 12 in Phase II. The primary research question asked was what are the geography attitudes and experiences of freshman students scoring at the low and high ends of a geographical literacy survey? The students had positive attitudes regardless of how they performed on the GLS. The study included a quantitative sub-question regarding the performance of the students on the GLS. The students’ performance on the GLS was equivalent to the performance of 12th grade students from the NAEP Assessment. There were three qualitative sub-questions from which the following themes were identified: the students’ definition of geography is limited, students recall more out of school experiences with geography, and students find geography valuable. In addition, there were five emergent themes: there is a concern regarding a lack of geographical knowledge, rote memorization of geographical content is overemphasized, geographical concepts are related to other subjects, taking the high school level AP Human Geography course is powerful, and there is a need for real-world applications of geographical knowledge. The researcher offered as suggestions for practice to reposition geography in our schools to avoid misunderstandings, highlight its interconnectedness to other fields, connect the material to real world events/daily decision-making, make research projects meaningful, partner with local geographers, and offer a mandatory geography courses at all educational levels.